EP2957254A1 - Procédé de fabrication de gouttières orthodontiques - Google Patents

Procédé de fabrication de gouttières orthodontiques Download PDF

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Publication number
EP2957254A1
EP2957254A1 EP14173051.5A EP14173051A EP2957254A1 EP 2957254 A1 EP2957254 A1 EP 2957254A1 EP 14173051 A EP14173051 A EP 14173051A EP 2957254 A1 EP2957254 A1 EP 2957254A1
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EP
European Patent Office
Prior art keywords
tooth
virtual
dimensional
state model
area
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EP14173051.5A
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German (de)
English (en)
Inventor
Gerhard Polzar
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Individual
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Individual
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Priority to EP14173051.5A priority Critical patent/EP2957254A1/fr
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/08Mouthpiece-type retainers or positioners, e.g. for both the lower and upper arch

Definitions

  • the present invention relates to a method for producing orthodontic splints. Furthermore, the invention relates to the tooth rails available by this method.
  • a relatively modern method of regulating a malocclusion is described, for example, in US Pat DE 698 18 045 T2 described.
  • this method of repositioning teeth from an initial tooth assembly to a target tooth assembly the affected teeth are incrementally moved, that is, incrementally, with a series of matched tooth rails.
  • This method is also referred to in the art as Aligner therapy.
  • To get to suitable tooth rails recommends the DE 698 18 045 T2 to generate a plaster cast from the patient's teeth before beginning the actual treatment, which is then used to obtain a digital representation of the teeth by means of suitable scanning techniques.
  • the plaster impressions of the upper and lower rows of teeth of the patient should be arrangeable relative to one another in a centric occlusion position.
  • the present invention therefore an object of the invention to provide a method and a system for orthodontic treatment of malocclusions, which is very comfortable to wear for the patient, but without mechanically overstraining the teeth to be regulated, the surrounding tissue and the associated tooth roots , In addition, such a procedure should bring as few visits to the doctor.
  • toothed rails or a set of coordinated toothed rails are obtained, with which teeth can be moved stepwise from a tooth misalignment to a desired target tooth position in accordance with the aligner therapy.
  • the plurality of tooth rails obtained by the method thereby depicts the gradual progress of the course of the treatment.
  • each dental splint is only worn by the patient until the teeth have reached the predetermined position by this dental splint.
  • the next toothed rail from the series of toothed rails is placed on the teeth.
  • selected teeth are specifically applied with force to move them to a change in position in a predetermined by the toothed rail circumference.
  • a dental splint of the set or plurality of splints is to be worn by the patient for a period of about two to four weeks until a change to the subsequent splint can be made from the set of splints.
  • an incremental change of the tooth misalignment in the direction of the desired target tooth position is effected.
  • a plurality of tooth rails in the context of the present invention regularly comprises two, three, four, five or more tooth rails. In many cases, a set of 20 to 50, for example 25 to 40 tooth rails is needed to reposition teeth from a misalignment to a target position.
  • the individual splints are generally to be worn for a period of two to four weeks.
  • toothed rails obtained by the method according to the invention, it can be ensured that in each individual treatment step, ie with each successive dental splint, a mechanical load is generated on the teeth to be moved, which is beneficial for the treatment success, without, however, the described risks such as tooth root degeneration. to have to accept surrounding tissue and / or jawbone.
  • step a use may be made in particular of digital volume tomography (DVT), computed tomography (CT), rotational angiography or phase contrast X-raying.
  • DVD digital volume tomography
  • CT computed tomography
  • rotational angiography or phase contrast X-raying.
  • the methods mentioned above are to be subsumed under 3D X-ray.
  • the digital volume tomography has proved to be particularly useful.
  • the radiation exposure of the patient can be minimized.
  • the digital data obtained by means of 3D X-ray can be supplemented by data obtained by means of 3D ultrasound.
  • the process steps d), e), f) and g) can be varied in their order as long as practicable.
  • some or all of the intermediate state models according to step e) also be generated before the target state model.
  • first the corresponding tooth model can be generated. That is, it is not necessary in the sense of the present invention that initially all intermediate state models are generated.
  • the amount of data to be processed can be significantly reduced without, however, having to accept losses in the information relevant here.
  • a surface presentation from the extracted 3D data including the extracted 3D voxel set
  • surface-based visualization methods known to those skilled in the art can be used.
  • Object surfaces are reconstructed directly from voxel data.
  • surface-based rendering the use of splines and triangular meshes is regularly used for surface description. Particularly preferred is the use of STL data sets.
  • Point-based rendering is an alternative to surface-based rendering, such as triangle rendering. Especially when rendering complex 3D models with very high detail requirements, the projected area of triangles may be smaller than one pixel. In such cases it is often useful to use single points as a rendering primitive.
  • step c With the virtual three-dimensional initial state model M l obtained in step c), the digital data set on which this virtual state model is based is included in the sense of the invention. The same applies to the initial state model obtained according to process variant ca) to cc). In the following steps, eg step d), in this connection, using the virtual three-dimensional initial state model M 1, use can be made of the underlying digital data record. The same applies to the use of the virtual three-dimensional intermediate state models and the virtual three-dimensional goal state model.
  • step cc) which is suitable and designed for the spatial screen display of the virtual three-dimensional initial state model M i in step d) and optionally step e) is used as in accordance with FIG Step c) obtained virtual three-dimensional initial state model M l .
  • the tissue surrounding the tooth comprises the mucosa and / or the gingiva, in particular fixed.
  • the method according to the invention also provides tooth rails which are particularly suitable for the respective specific application case, if it is considered that in step e) the extent of the incremental change of at least one tooth in the direction of the target state model M n is determined as a function of the size and / or orientation of the associated tooth root and / or in step e) determines the extent of the incremental change of at least one tooth in the direction of the target state model M n as a function of the thickness of the enamel of the associated tooth becomes.
  • the Vordertimewandung that remindewandung and optionally also the support element of at least one tooth rail model Z i, respectively, or together, are adjustable or equipped with a substantially uniform thickness.
  • the support element connects Vorderacted- and back wall of the toothed rail models or tooth rails.
  • the support element can, but does not always lie inside on a tooth crown.
  • the outer side of the support element regularly forms the main attack or occlusal surface for the tooth or teeth opposite the jaw.
  • the Vorderfelwandung and / or the remindatwandung and optionally also the support element of at least one tooth rail model Z i are each adjustable or equipped with a substantially non-uniform thickness, in particular with at least a first area with respect to surrounding areas of different, in particular larger, thickness.
  • a particularly positive course of treatment can also be achieved in that the front side wall and / or the rear side wall have at least one first area with a greater thickness than adjacent second areas and that this at least one first area of greater thickness corresponds to the position of a tooth Incrementally to change position.
  • the thickness of the toothed rail is greater in one section than in the surrounding, adjacent areas, at this point, the tooth to be moved can be specifically acted upon with a force adapted to the desired repositioning.
  • greater thickness means that a greater extent on the inside of the front side and / or rear side wall, in particular the front side wall, in the direction of the tooth is thereby accompanied.
  • the region of the lower edge of the front wall and / or the rear wall of the dental splint i. the support element of the toothed rail opposite, the respective wall of the toothed rail thicker and / or harder to design.
  • This thickening in the edge region preferably extends only on the outside. This regularly results in a more pronounced transverse stabilization.
  • toothed rack models Z i are created for upper and lower jaw, their respective support elements taking into account initial state model M l and Target state model M n is coordinated.
  • support elements may represent occlusal surfaces which correspond to the occlusal surface of the tooth crowns respectively opposite the bite.
  • the support element can be designed such that the desired incremental change in position is supported by the interaction in the bite with the opposite tooth crown.
  • Special treatment goals can also be achieved by creating toothed rail models Z i for upper or lower jaw, whose support elements, in particular in the posterior region, have at least one ramp or at least one depression.
  • These so-called occlusal bites or ramps, elevations and depressions can be used to control the bite of the sagittal bites in the posterior region.
  • a backbite or a Vorbiss be dealt with or at least taken into account.
  • influence can be exerted on the development of a necessary anchorage for the tooth movement.
  • the bite position can be controlled vertically with bites also in the front, with deep bites and open bites.
  • lateral deviations in asymmetric dentition anomalies can be corrected in this way.
  • the front wall and / or the rear wall have at least one third area with a different consistency from adjacent fourth areas and / or with a different wall structure and / or with a different hardness and that this is at least a third Area corresponds to the position of a tooth whose position is to be changed incrementally.
  • a variant of this type has proven to be particularly suitable in which the inside of the front side wall and / or the rear wall and optionally also of the support element is provided with at least one fifth area with a surface structure which is more pronounced than adjacent sixth areas, in particular comprising a groove-like or cone-shaped surface structure. and / or are adjustable or equipped with a more elastic material.
  • the inside of the front and / or rear wall of the toothed rail has grooves, there is preferably a multiplicity of grooves running substantially parallel. These grooves preferably extend transversely to the tooth axis, ie to the axis which extends from the root in the direction of the bearing surface of the tooth.
  • the grooves may in a preferred embodiment, a groove depth in the range of 0.001 mm to 0.4 mm, preferably in the range of 0.01 to 0.1 mm. It has proven particularly expedient to equip the inside of the front side and / or rear side wall with a large number of pins or suppositories. In this case, the multiplicity of pegs or suppositories preferably lies adjacent to one another, so that at least one contiguous peg area or suppository area is formed.
  • the height of the pins or suppositories is in an expedient embodiment in the range of 0.001 mm to 0.4 mm, preferably in the range of 0.01 to 0.1 mm.
  • the grooves and pins or suppositories are designed to be more elastic in a preferred embodiment than the further removed from the inside of the toothed rail areas.
  • a better adhesion of the toothed rail to the tooth is generally possible. This is regularly accompanied by a more effective incremental displacement of the affected tooth.
  • Treatment successes tailored to the particular patient are particularly advantageous with such a further developed method according to the invention, which further comprises computer-assisted virtual isolation of at least one tooth together with associated tooth root, periodontal skin, enamel, jawbone and / or surrounding tissue, in particular the associated complete periodontium apparatus, and Use of the data obtained in this isolation in steps d), e), f) and / or g).
  • Alveolar ridge and septum can be incorporated into the screen display in this way and help to be able to optimally adjust the degree of repositioning to be carried out per dental splint.
  • the toothed tracks are produced directly from the digital data records obtained by means of a rapid prototyping method, without requiring the production of models.
  • Suitable rapid prototyping processes according to step g) include lithographic, in particular stereolithographic, processes, laser sintering processes, layer laminate processes, thermojet processes, fused layer modeling, 3D Print method, DLP mask technique method and 3D Plott method.
  • the method according to the invention is characterized in that it enables the treating specialist to be able to produce the set of tooth rails required for the repositioning himself.
  • the whole process from detecting and analyzing tooth misalignment to determining the sequence of steps to a target tooth position until the production of the required tooth rails can be made in one and the same treatment practice. This reduces the overall treatment time and reduces the number of visits to the doctor.
  • the material of the tooth rails which are obtained by means of rapid prototyping, is known to the person skilled in the art.
  • polymeric plastics or polymer compounds which can be polymerized to such plastics are used regularly, e.g. Epoxy-based resins, optionally containing at least one plasticizer, or (meth) acrylic acid and / or (meth) acrylic esters.
  • Epoxy-based resins optionally containing at least one plasticizer, or (meth) acrylic acid and / or (meth) acrylic esters.
  • the previously listed generative methods of rapid prototyping are also familiar to the person skilled in the art.
  • Transparent tooth rails are often based on poly (meth) acrylate (co) polymers.
  • the object underlying the invention is further solved by a, in particular transparent, orthodontic dental splint, in particular a set of, in particular transparent, orthodontic splints, obtained by a rapid prototyping method using 3D X-ray and optionally, in combination herewith by 3D sonography, of teeth and associated periodontal apparatus comprising tooth roots, enamel, periodontal, jawbone and surrounding tissue, digital data sets generated by the mandible and / or maxilla.
  • those orthodontic splints which have been obtained by the method according to the invention are particularly preferred.
  • such orthodontic dental splints are particularly preferred, comprising a front and a rear side wall and the front and the rear side wall connecting support element, wherein the front and / or rear wall and optionally also the support element over at least a first area with one opposite to adjacent second areas of greater thickness and wherein said at least one first area of greater thickness corresponds to the location of a tooth whose position is to be changed incrementally, and / or wherein the front side wall and / or the rear side wall and possibly also the support element have at least a third area with a different consistency to adjacent fourth areas, a different wall structure and / or a different hardness and wherein said at least one third area corresponds to the position of a tooth whose position is to be changed incrementally, and / or wherein the inside of the front wall and / or the back wall and optionally Also, the support element over at least a fifth area with a relation to adjacent sixth areas more
  • first and the third area or the first and the fifth area or the third and the fifth area or the first, third and fifth area are substantially congruent and / or that the second and fourth area or the second and sixth areas or the fourth and sixth areas or the second, fourth and sixth areas are substantially congruent.
  • those regions of a dental splint ZS i or of a splint model Z i that surround or grasp teeth that are not to undergo an incremental positional change with this dental splint ZS i or the underlying splint splint model Z i can be used with a larger one Provide wall thickness and / or hardness, so that these teeth undergo a pronounced anchoring and thus stabilization of their situation.
  • this approach has the advantage that by using harder and / or thicker areas in the areas where the teeth are not to be moved incrementally, a more targeted application of force is achieved in those areas in which a tooth is to be moved incrementally ,
  • the present invention was based on the surprising finding that, taking into account the position, orientation and size of the tooth roots as well as the surrounding tissue, a series of tooth rails can be designed and manufactured for the incremental change of a tooth misalignment, which not only takes individual circumstances into consideration contributes that one progressively reaches from a tooth malposition in the initial state to a desired tooth target position, but that in this case neither the tooth roots nor the surrounding tissue or the associated jawbone areas of the moving teeth or adjacent teeth are affected, not even after a delay after completion of the treatment.
  • FIG. 1 shows a schematic sectional view through a tooth 1 with tooth support apparatus 2 and the tooth 1 enclosing this section of a dental splint 4.
  • the dental splint 4 has been calculated and prepared by 3 D rapid prototyping that the insides of Vorderactedwandung 6, support surface 8 and back wall 10 abut the outline 12 of the tooth 1.
  • the outline 12 of the tooth 1 is regularly formed by the tooth enamel.
  • the toothed rail 4 does not have a uniform thickness in the illustrated embodiment.
  • Both at the opposite side of the support surface 8 edge 14 of the front side wall 6 and on the support surface 8 opposite edge 16 of the rear side wall 10 are outwardly thickened material regions 18 and 20 before. This achieves a noticeable transversal stabilization of the teeth according to the invention subjected to orthodontic treatment.
  • the toothed rail 4 has a thickening in the form of an inward bulge in the direction of the tooth 1 in a section 22 of the front side wall 6.
  • Such thickened regions can purposefully force the incremental displacement of a specific tooth in the desired direction. For example, it is no longer necessary to stick spacers to the tooth in order to achieve a corresponding effect in interaction with a regular toothed rack of uniform thickness.
  • FIG. 2 shows the detail A from the toothed rail 4 according to FIG. 1 ,
  • the thickness d of the toothed rail in this area is approximately 0.7 mm in the illustrated embodiment.
  • the inside of the toothed rail 4 is provided with a plurality of adjacent suppositories 24.
  • These suppositories 24 may, for example, have a height which corresponds to one twentieth to one fifth of the thickness of the dental splint 4, for example 0.07 mm.

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)
EP14173051.5A 2014-06-18 2014-06-18 Procédé de fabrication de gouttières orthodontiques Withdrawn EP2957254A1 (fr)

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EP14173051.5A EP2957254A1 (fr) 2014-06-18 2014-06-18 Procédé de fabrication de gouttières orthodontiques

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EP14173051.5A EP2957254A1 (fr) 2014-06-18 2014-06-18 Procédé de fabrication de gouttières orthodontiques

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EP2957254A1 true EP2957254A1 (fr) 2015-12-23

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018064782A1 (fr) * 2016-10-07 2018-04-12 Coobx Ag Gouttière constituée d'un composite stratifié
CN111067645A (zh) * 2018-10-18 2020-04-28 冯慧 用于移动牙齿系统

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20010041320A1 (en) * 2000-04-25 2001-11-15 Loc Phan Systems and methods for varying elastic modulus appliances
DE69818045T2 (de) 1997-06-20 2004-06-03 Align Technology, Inc., Redwood City Verfahren und system für auf inkrementale weise bewegende zähne
US20080254402A1 (en) * 2006-10-16 2008-10-16 Jack Keith Hilliard System for producing orthodontic aligners by cnc machining
US20080268400A1 (en) * 1998-10-08 2008-10-30 Align Technology, Inc. Dental appliance reinforcement
US20090246724A1 (en) * 2008-03-25 2009-10-01 Yan Chen Restorative dental appliances
US20110020761A1 (en) * 2006-08-21 2011-01-27 Thomas Kalili Orthodontic Repositioning Applicance
US7963765B2 (en) * 2002-09-20 2011-06-21 Ortho-Tain, Inc System of dental appliances having various sizes and types and a method for treating malocclusions of patients of various ages without adjustments or appointments
US20120214121A1 (en) * 2011-01-26 2012-08-23 Greenberg Surgical Technologies, Llc Orthodontic Treatment Integrating Optical Scanning and CT Scan Data
EP2581062A2 (fr) * 2011-10-12 2013-04-17 Ormco Corporation Fabrication directe d'un aligneur orthodontique

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE69818045T2 (de) 1997-06-20 2004-06-03 Align Technology, Inc., Redwood City Verfahren und system für auf inkrementale weise bewegende zähne
US20080268400A1 (en) * 1998-10-08 2008-10-30 Align Technology, Inc. Dental appliance reinforcement
US20010041320A1 (en) * 2000-04-25 2001-11-15 Loc Phan Systems and methods for varying elastic modulus appliances
US7963765B2 (en) * 2002-09-20 2011-06-21 Ortho-Tain, Inc System of dental appliances having various sizes and types and a method for treating malocclusions of patients of various ages without adjustments or appointments
US20110020761A1 (en) * 2006-08-21 2011-01-27 Thomas Kalili Orthodontic Repositioning Applicance
US20080254402A1 (en) * 2006-10-16 2008-10-16 Jack Keith Hilliard System for producing orthodontic aligners by cnc machining
US20090246724A1 (en) * 2008-03-25 2009-10-01 Yan Chen Restorative dental appliances
US20120214121A1 (en) * 2011-01-26 2012-08-23 Greenberg Surgical Technologies, Llc Orthodontic Treatment Integrating Optical Scanning and CT Scan Data
EP2581062A2 (fr) * 2011-10-12 2013-04-17 Ormco Corporation Fabrication directe d'un aligneur orthodontique

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2018064782A1 (fr) * 2016-10-07 2018-04-12 Coobx Ag Gouttière constituée d'un composite stratifié
CH713017A1 (de) * 2016-10-07 2018-04-13 Coobx Ag Dentalschiene bestehend aus einem Lagenverbund.
CN111067645A (zh) * 2018-10-18 2020-04-28 冯慧 用于移动牙齿系统

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